Health Of Residents Research Articles

The Impact of Built Environment in Shanghai Neighborhoods on the Physical and Mental Health of Elderly Residents: Validation of a Chain Mediation Model Using Deep Learning and Big Data Methods

As urban aging issues intensify, the impact of the built environment in urban neighborhoods on the physical and mental health of elderly residents has garnered increasing attention. Previous studies have demonstrated that the built environment is related to various health outcomes; however, most empirical research typically focuses on the objective physical environment, lacking measurements of subjective environmental perceptions. This study, using 24 neighborhoods in Shanghai as case studies, employed deep learning, big data methods, and surveys to collect 462 valid questionnaires from elderly residents. Structural equation modeling was applied to explore the relationship between the built environment and the physical and mental health of elderly residents, incorporating respondents’ subjective perceptions, physical activity, and neighborhood relationships as chain mediation effects. The results indicate that although there is no direct relationship between the built environment and the mental health of elderly residents, the built environment positively impacts mental health through enhancing subjective.

Green Streets, Healthy Hearts: Exploring the Roles of Urban Nature and Walkability in Cardiovascular Health.

With the growing evidence that connects urban environments with public health outcomes, the role of urban planning has become increasingly critical in addressing public health challenges. Cardiovascular diseases (CVDs) are the leading cause of mortality in urban areas and worldwide and are impacted by characteristics of the built environment, such as walkability and nature exposure. In this literature view, we explore the influence of the physical built environment, specifically green spaces and walkability, on cardiovascular health. Results from prior studies show a clear reduction in cardiovascular disease-related risk factors, morbidity, and mortality in neighborhoods that integrate green spaces and/or walkability. Cumulative evidence suggests that urban environments that integrate green spaces (such as parks) and walkability (eg, safe sidewalks) can significantly improve cardiovascular health. Urban planning policies and strategies that prioritize the integration of green infrastructure and walkable designs can contribute to improving cardiovascular health in urban residents while also enhancing the overall well-being and quality of life.

Perceptions of improvements and mental health outcomes of micro-renewal in old Danwei community: a survey of residents in Hengyang, China

IntroductionDanwei communities are a testament to China’s socialist urban development, characterized by the self-sufficiency, strong social networks, and institutional management. In the historical context of urban development in China, many old communities have evolved from former housing areas of Danwei. After more than 40 years of use, the buildings, and environments in the old Danwei communities remain in disrepair, dirty, disorderly and poor condition. Many functions have failed that negatively affect the quality of life and health of residents. After Covid-19, improving the mental health of residents has become a major goal of public policies in various countries.MethodsTo explore the residents’ mental health in the micro-renewal, this study carried out a survey regarding residents’ evaluation on the micro-renewal and their mental health in two renewed Danwei communities in Hengyang, China. More than 800 respondents joined the interview, among them, 634 samples are effective for analysis. Entropy-TOPSIS is applied to analyze the weights of various indicators of micro-renewal. And multinominal logit model is used to examine the relationship between the personal factors, satisfaction on various items of micro-renewal and mental health.Results and DiscussionThe findings indicates that the mental health level of residents living in Danwei community is affected by micro-renewal. The socio-demographic characteristics and behavior factors can influence on the possibility of being in different levels of mental health. The satisfaction on the components of micro-renewal and improvements after micro-renewal is also determiner of residents’ mental health level. In addition, the heterogeneity is address in mental health.

Nurse-led framework to improve the safety and quality of residential aged care (HIRAID® Aged Care): protocol for a stepped-wedge cluster randomised controlled trial

BackgroundThe health issues experienced by older people can often be severe and complex, and an increasing number are using residential aged care services to meet their care needs. High-quality nursing care is fundamental to the health and safety of aged care residents and is contingent on nurses’ accurate assessment, informed decision-making, and delivery of timely interventions. However, the role of the aged care nurse is often challenging, impeded by factors such as understaffing, high workloads, and a lack of access to clinical infrastructure and resources. When these challenges mount, residents are put at greater risk of adverse outcomes, such as avoidable clinical deterioration and hospital transfers. This study describes the adaptation and implementation of the emergency nursing framework, HIRAID® (History including Infection risk, Red Flags, Assessment, Interventions, Diagnostics, reassessment, communication and plan)—a tool to assist nurses’ assessment, decision-making and care in residential aged care.MethodsThe HIRAID® framework will be adapted for residential aged care using a real-time Delphi and panel of aged care and nursing experts. The co-designed HIRAID® Aged Care framework will be trialled in 23 residential aged care homes in Sydney, Australia, in a modified stepped-wedge cluster randomised controlled trial design. All homes will be randomised into one of four clusters. Outcomes of interest include the rate of clinical deterioration events resulting from nurses’ actions, the rate of hospital transfers determined to be inappropriate, performance against the national mandatory aged care quality indicators, resident satisfaction with care, nurse and medical staff satisfaction with communication, and the quality of nursing documentation. These outcomes will be evaluated using a combination of qualitative and quantitative analysis of routinely collected resident data, expert assessments of facility documentation events against validated criteria, and pre- and post-intervention surveys of residents, family carers, nurses, and medical staff.DiscussionThis protocol describes a pragmatic trial that aims to translate an evidence-based framework from the emergency care context into residential aged care. The adapted HIRAID® Aged Care framework will be the first of its kind to standardise and guide holistic nursing assessment, decision-making, and documentation in residential aged care in Australia.Ethics and disseminationThis research has been approved by the Western Sydney Local Health District Human Research Ethics Committee: 2023/ETH00523. A waiver of consent has been approved to access resident health data and nursing documentation at each participating site.Trial registrationAustralian and New Zealand Clinical Trial Registry, ACTRN12623000481673. Registered 12 May 2023.Protocol versionVersion 1.0 6 February 2024.

Environmental And Health Implications of Waste Disposal Sites In The Lesotho Lowlands

Many Southern African countries, including Lesotho, face severe health and environmental issues attributed to waste disposal. The purpose of this study is to assessed the environmental and health impacts on residents living in proximity to disposal sites in the lowlands of Lesotho. A descriptive cross-sectional design was employed, using a semi-structured questionnaire and observation method. A mapping device was used, and photographs were taken to validate the findings. Descriptive statistics and the Chi-square test (?²) were employed to analyze the data. Results indicate that in Lesotho, some landfill sites are located as close as 50 meters from residential areas, and most (60%) received hazardous mixed waste streams. Waste burning and backyard dumping were the most frequently used disposal methods by residents. Several perceived health outcomes and environmental issues were noted, with respiratory and gastrointestinal health issues being the most prevalent. There was a statistically significant association between waste burning and respiratory diseases (P < 0.010) and between backyard dumping and gastrointestinal diseases (P < 0.003). The study concludes that regulatory instruments need to be revised and enforced, requiring hazardous waste producers to take responsibility for end-of-life waste and banning the entry of such waste into disposal sites. The application of waste management strategies to initiate other preferable end-of-life waste procedures, such as recycling of WEEE and waste-to-energy technologies for organic waste in Lesotho, could improve the quality of health for residents and their environment.

The health impact of PM2.5 and O3 in Beijing modified by infiltration factors from 2014 to 2022.

PM2.5 and O3 are significant threats to the health of residents and modern residents spend more than 80% of their time indoors, so quantifying indoor exposure of residents has a positive influence on formulating policies and improving health indicators. Analysis of monitoring data shows a consistent decrease in the annual average concentration of outdoor PM2.5 in Beijing from 90.1 to 30.4μg/m3, and the equivalent human exposure concentration also declined from 55.2 to 18.6μg/m3 modified by infiltration factors from 2014 to 2022, while during the peak season, the average value of O3-8h concentration in Beijing has consistently remained between 159.3 and 225.3μg/m3; the equivalent human exposure concentration remained between 64.7 and 92.3μg/m3 modified by infiltration factors from 2014 to 2023. The equivalent exposure concentration is calculated by weighting the concentration of indoor and outdoor pollutants, the proportion of indoor and outdoor activity time of the population, and the permeability coefficient of outdoor pollutants into the room, so as to quantify the actual concentration of pollutants exposed to the human body in a certain time. Previous studies have primarily focused on the impact of annual changes in pollutant concentrations on health estimates, often neglecting indoor concentrations and behavior patterns. This limitation should be addressed. Therefore, this study utilized equivalent human exposure concentration and AirQ + , the authoritative software released by the World Health Organization (WHO), to evaluate quantitatively the impact of PM2.5 and O3 on the health of Beijing residents by combining pollutant concentration, annual population, and mortality of various diseases and other indicators to enhance the credibility of the study. The number of deaths related to PM2.5 has decreased from 28,182 people in 2014 to 10,250 people in 2022 (age ≥ 30). The number of premature deaths in 2022 was only 36.4 percent of that in 2014 and was decreasing by 1992 per year. The number of deaths related to O3 varies between 550 and 3358 people. Lowering PM2.5 and O3 concentrations can effectively reduce natural premature death as well as cardiovascular and respiratory diseases caused by air pollution. The government should persist in enhancing the regulation of PM2.5 and accord significance to the oversight of O3. Concurrently, there is a need to reinforce the cooperative regulation addressing both PM2.5 and O3.

The Impact of Urban Architecture on the Lifestyle and Health of the People of Mehrauli, South Delhi

This research investigates the intricate relationship between urban design and its influence on human health and lifestyle, focusing on the specific case of Mehrauli, South Delhi. The study aims to understand how urban development can affect public health and explore the principles of New Urbanism that could mitigate these risks. Through a mixed-method approach, the study analyzes the impact of various architectural factors, such as building design, green spaces, and infrastructure, on the physical and mental health of residents. The research delves into specific health concerns, including non-communicable diseases, mental health issues, and the overall quality of life in the urban environment. By examining existing literature and conducting surveys among residents, the study identifies key areas where urban architecture can be improved to promote healthier lifestyles and enhance the overall well-being of the community. The findings offer valuable insights for policymakers, urban planners, and architects to create more sustainable and health-promoting urban environments.

Alternative forms of housing for longevity based on case studies of multigenerational houses in Poland

The subject of the article is a case study analysis of three experimental projects of multigenerational houses that emerged after 2019 in Polish cities. The author hypothesizes that multigenerational houses represent an alternative form of housing to nursing homes, creating an environment that supports the health and independence of residents of different ages for as long as possible. The purpose of the research conducted is to answer the question of what components of the support system for the elderly are important in the choice and intentional transition to alternative living arrangements and how this relates to multigenerational homes in the cases studied. The research in this article consists of four phases. The first phase examined the institutional and informal approach to organizing care for the elderly in Poland and outlined the components of the support system for the elderly that are necessary for the choice and conscious transition to alternative forms of housing in the aging process. In the second phase, the experience with the governmental program "Multigenerational House" in Germany was analyzed and a multigenerational house was defined. In the third phase, the case study method was used to examine the experience of multigenerational houses built and functioning in Polish cities in recent years: Multigenerational House in Łódź (2019), Multigenerational Housing in Warsaw (2019-2021), Multigenerational House in Wrocław (2020). In the fourth phase, based on the literature review and the analysis of functioning multigenerational houses, a comparative analysis was made and conclusions for further research were drawn.

Water pollution: causes, impacts and current efforts to address the issues of water pollution along river Meizimera-kihihi, Kanugu District,Uganda.

Pollution refers to the addition of harmful substances to that level where they cause an effect on the environment, it has three major categories such as water, soil, and air pollution but this report is on water pollution. It occurs when harmful substances contaminate water bodies such as, groundwater, rivers, lakes, and oceans rendering them unfavorable for various purposes for example drinking, recreation, and support to aquatic life. Globally, over 80% of wastewater worldwide is discharged into the water bodies without adequate treatment. In Africa, lack of clean water and sanitation is a significant challenge in many countries, affecting approximately 319 million people. Thus, water pollution is one of the types of pollution that has been threatening the lives of living organisms. Implementing effective policies and strategies can have a profound impact on the environment and local communities. By reducing pollution levels and improving water quality, we can create a healthier environment and decrease the incidence of waterborne diseases, leading to improved health and well-being for residents. The research on water pollution in the River Meizimera Kihihi has important implications for future research, policy and governance, human health, the environment, and communities and society. In conclusion, effective policies can foster community involvement, raise awareness, and promote collective action to address water pollution. By achieving clean water and sanitation (SDG 6), we can contribute to the broader sustainable development goals. This research has important ramifications for future research, policy and governance, human health, the environment, communities, and society. This study investigated the problems of water pollution, its causes, its impact, and the current effort to address the issues along the river of Meizimera-kihihi, Kanugu district, Uganda. Recommendations were made, which included encouraging the adoption of sustainable agricultural practices, industrial processes, and waste management strategies to minimize pollution.

The clinical characteristics and prognosis of patients with acute ST-segment elevation myocardial infarction complicated with impaired activity daily living

Abstract Background Previous studies have indicated that activities of daily living (ADL) can influence the prognosis of patients with acute myocardial infarction. The purpose of this study is to delineate the clinical characteristics, treatment regimens, and prognosis of patients with acute ST-segment elevation myocardial infarction (STEMI) who have impaired ADL. Methods The data for this study were derived from a Health and Medical Big Data Superplatform, comprising a retrospective cohort of patients admitted to and discharged from 72 secondary and tertiary hospitals from 2010 to 2023. The inclusion criteria encompassed patients with a discharge diagnosis of STEMI.ADL prior to STEMI was evaluated using the Barthel index(BI),a widely used assessment tool for evaluating ADL.The patients' BI were obtained from their resident health records.Patients were categorized into two groups: ADL normal group and ADL impaired group. A comparative analysis was conducted between the two groups regarding clinical characteristics, treatment regimens, and prognosis. Results This study included 24,906 STEMI patients with normal ADL and 1,002 STEMI patients with impaired ADL. Baseline data revealed that patients in the ADL impaired group had a higher proportion of females (43.0% vs. 37.8%, p=0.001), were older (74.0[64.0,81.0] vs. 69.0[65.0,75.0], p<0.001), and had a higher proportion of Killip III and above (24.30% vs. 14.10%, p<0.001). Additionally, the ADL impaired group had a higher prevalence of comorbidities. In terms of treatment, the ADL impaired group had lower proportions of patients undergoing percutaneous coronary intervention (PCI) (43.8% vs. 65.3%, p<0.001) and primary PCI (PPCI) (36.4% vs. 55.1%, p<0.001). Additionally, the ADL impaired group exhibited lower utilization rates of antiplatelet drugs, ACEI/ARB, beta-blockers, ARNI, and statins, but higher rates of diuretics and cardiac glycosides. Regarding prognosis, the ADL impaired group had a higher in-hospital mortality rate (5.69% vs. 2.89%, p<0.001). The median follow-up time was 1,220 days. In the ADL impaired group, the rates of all-cause mortality (52.0% vs. 24.7%, p<0.001), cardiovascular mortality (37.3% vs. 17.3%, p<0.001), recurrent non-fatal myocardial infarction (11.1% vs. 8.30%, p=0.002), and recurrent stroke (11.9% vs. 8.66%, p=0.001) were higher. However, the rate of revascularization was lower in the ADL impaired group (6.69% vs. 9.20%, p=0.008), and the risk of cerebral hemorrhage showed no significant difference (1.00% vs. 0.81%, p=0.631). In a multivariate Cox regression analysis adjusting for age, gender, Killip, medical history, and treatment strategies, impaired ADL remained an independent risk factor for increased all-cause mortality (aHR 1.309, 95% CI: 1.195-1.434, p<0.001). Conclusions Impairment of ADL is associated with adverse clinical outcomes in patients with STEMI.Baseline characteristics of patientsMedications of patients

7.F. Scientific session: Living lab Cartesius: multidisciplinary cooperation for health monitoring of an ‘urban blue zone’

Abstract This workshop will be based on health monitoring in living lab Cartesius; a neighbourhood that is currently developed in the city of Utrecht, the Netherlands (Home - Cartesius Utrecht (cartesius-utrecht.nl). The design of this neighbourhood is inspired by the concept of the “blue zones” of Pes and Poulain, places in the world, that they argue are inhibited by the healthiest, longest-living populations because they integrate sustainability, climate adaptation and healthy living. In Cartesius citizens will for example be encouraged to move by inviting outer spaces, meet each other in the community areas and eat healthily nudged by the food options in the food court. An important element of these blue zones is the incorporation of green spaces in the neighbourhood. Examples are (community) parks/gardens, a green walking route around the neighbourhood, trees in the bike parking lots, green facades etc. The neighbourhood is designed to become a home to local species such as plants and animals as well as people. In addition, climate change adaptation is incorporated, the appartements are well insulated and contain solar panels and green and white roofs. Preventing heat stress is considered in the green design of the outdoor spaces and special drainage and water storage equipment throughout the neighbourhood. The municipality has been closely involved in this project from the start, they created the call for developers to create a healthy urban neighbourhood and after selecting the Cartesius project they have remained involved in its development. Of special interest to the municipality is community building (in new neighbourhoods) in order to strengthen social cohesion and prevent loneliness. We will conduct a research on this topic of which the results could permanently impact how new neighbourhoods in Utrecht will be approached. Designers, developers, research institutes, governments and the current inhabitants are now collectively working on a holistic monitoring programme in this neighbourhood to collect evidence for the effects of the “blue zone” interventions and design choices on behaviour, health and well-being of residents. This workshop will focus on various aspects of the Blue Zone Concept, the importance of green in urban living, the participatory role of local residents, the role of stakeholders and the relevance for local governance. First of all the participants will be informed about a unique healthy/green urban living concept based on the blue zones currently in development. The participants will get insights in the process of developing a new healthy neighbourhood where different challenges (e.g. climate adaptation, community building, healthy living environment) are experimented with stakeholders from the quadruple helix (private, government, science and societal stakeholders). Simultaneously, we want to allow room for ample time for audience interaction to share their experiences on similar multi transdisciplinary cooperations and monitoring strategies. Key messages • This session will provide room for knowledge exchange in the area of healthy urban living and transdisciplinary collaboration. • Specific focus on holistic monitoring of the effectiveness of health interventions in urban living areas and (international) policy implications. The concept of Cartesius The workshop will start with a presentation about the concept of the Cartesius neighbourhood. The incorporation of the elements of the Blue Zones will be discussed and images of both the current state of the development and artist impressions of the future finished neighbourhood will be presented. Room for (among other topics) discussion about the ‘translation’ of the blue zone concept to this urban area. This presetntation will be done by Marije Lammers (University Utrecht, postdoc and coordinator monitoring programme healthy urban living in Cartesius) Incorporating citizens in monitoring 300 appartements in Cartesius are already realized, in which +/- 600 citizens are currently living. In a time span of about 8 years the number of apartments will have increased to 3000, with about 6000 inhabitants. The current citizens are involved in designing the monitoring strategy and community building approach. In order to measure effectively whether the health interventions in Cartesius will impact the citizens’ health their involvement and cooperation is crucial. Room for (among other topics) discussion about involving citizens in monitoring and community building effectively. WHO Europe Healthy Cities This presentation will discuss how developments in the Cartesius neighbourhood are in line with WHO Europe Healthy Cities ambitions for bringing about change and achieving improved health, well-being and equitable and sustainable development in cities across the European Region and globally. Room for (among other topics) discussion about possibilities for international knowledge exchange and applications. This presentation will be by: Kira Fortune, Regional Advisor, Healthy Cities, Health Promotion and Well- being, World Health Organization

How can interventions of building renovation and household energy conversion effectively improve the physical and mental health outcomes? A systematic review and meta-analysis

Household energy efficiency measures can effectively reduce indoor air pollution and positively impact the health of residents, but there is no conclusive evidence on the effectiveness of different energy efficiency measures for various diseases. This study used systematic review and meta-analysis to research the effects of two interventions on residents’ physical and mental health: building renovation (heating, insulation, double-glazed windows and ventilation) and household energy conversion (stove upgrading and clean energy use). A total of 79 papers published between 1977 and 2023 were reviewed in this study, providing comprehensive meta-analytic evidence on the effectiveness of energy efficiency measures. The results show that household energy-saving measures have a minor but significant positive influence on residents’ physical and mental health, with the effect on mental health being larger than the impact on physical health. Stove upgrading is advantageous in respiratory and cardiovascular diseases; insulation can greatly reduce the risk of skin diseases; heating is beneficial in sensory and digestive diseases; and clean energy use can successfully mitigate integrative diseases. Furthermore, a combination of heating and insulation measures has the most favourable influence on mental health conditions such as depression, anxiety and social isolation. The study findings can help residents, policymakers and relevant organizations take appropriate interventions to promote residents’ physical and mental health.

Connecting Past to Present: Does Historical Redlining Affect Current Life Expectancy?

Previous research has documented a strong relationship between currently living in the redlined zones of the 1930s and suffering from a higher prevalence of disease. However, little is known about the relationship between historical redlining, modern-day redlining, and current resident health outcomes. This paper aimed to simultaneously model the associations between both historical redlining and modern-day redlining on current health outcomes. In this paper, we used structural equation modeling to uncover relationships between current and historical redlining practices and modern-day life expectancy, exploring two levels of potential mediating factors: (1) racial segregation and structural racism; and (2) mediating health outcomes. We analyzed data from 11,661 census tracts throughout the United States using historical redlining data from 1940, modern redlining data from 2010 to 2017, racial segregation and structural racism indices from 2010 to 2019, health outcome data from 2021 to 2022, and life expectancy data from 2010 to 2015. Historical redlining was measured using Home Owners' Loan Corporation (HOLC) ratings, which ranged from 1.0 for favorable neighborhoods ("greenlined") to 4.0 for unfavorable ("redlined") neighborhoods. Modern-day redlining was measured using Home Mortgage Disclosure Act (HMDA) data, which were transformed into four quartiles, ranging from level 1 (low mortgage rejection rates) to level 4 (high mortgage rejection rates). We found a significant relationship between historic redlining and current life expectancy, with average life expectancy decreasing steadily from 80.7 years in HOLC 1 tracts to 75.7 years in HOLC 4 tracts, a differential of 5.0 years between the greenlined and redlined tracts. We also found a significant relationship between modern-day redlining and current life expectancy, with average life expectancy decreasing steadily from 79.9 years in HMDA 1 tracts to 73.5 years in HMDA 4 tracts, a differential of 6.4 years. In the structural equation model, historical redlining had a total effect of decreasing life expectancy by 1.18 years for each increase of one in the HOLC rating. Modern-day redlining had a total effect of decreasing life expectancy by 1.89 years for each increase of one in the HMDA quartile. This paper provides new evidence that the legacy of redlining is not relegated to the history books but rather is a present and pressing public health issue today.

The clinical characteristics and prognosis of patients with acute non-ST-segment elevation myocardial infarction complicated with impaired activity daily living

Abstract Background Impaired activities of daily living (ADL) have been identified as an independent risk factor for cardiovascular diseases. This study aims to describe the clinical characteristics, treatment modalities, and prognosis of acute non-ST-segment elevation myocardial infarction (NSTEMI) patients with impaired ADL. Methods The data for this study were derived from a Health and Medical Big Data Superplatform, comprising a retrospective cohort of patients admitted to and discharged from 72 secondary and tertiary hospitals from 2010 to 2023. The inclusion criteria encompassed patients with a discharge diagnosis of NSTEMI.ADL prior to NSTEMI was evaluated using the Barthel index(BI),a widely used assessment tool for evaluating ADL.The patients' BI were obtained from patients’ resident health records, and patients were categorized into two groups: ADL normal and ADL impaired group. A comparative analysis was conducted between the two groups regarding clinical characteristics, treatment regimens, and prognosis. Results The study included 28,227 NSTEMI patients with normal ADL and 1,576 NSTEMI patients with impaired ADL. Baseline data revealed that the ADL impaired group had a higher proportion of females (49.4% vs. 43.2%, p < 0.001), older age (77.0 [69.0, 83.0] vs. 71.0 [66.0, 78.0], p < 0.001), and a higher proportion of patients with KILLIP III and above (25.86% vs. 17.44%, p < 0.001). Additionally, the ADL impaired group had a greater number of pre-existing comorbidities. Regarding treatment, the proportion of patients undergoing percutaneous coronary intervention (PCI) was significantly lower in the ADL impaired group (16.5% vs. 65.3%, p < 0.001). Moreover, the ADL impaired group showed lower utilization rates of antiplatelet agents, ACEI/ARBs, beta-blockers, ARNI, statins, and nitrates, while the utilization rates of diuretics and cardiac glycosides were higher. In terms of prognosis, the ADL impaired group exhibited a higher in-hospital mortality rate (6.03% vs. 3.35%, p < 0.001). During a median follow-up period of 876 days, the ADL impaired group had significantly higher rates of all-cause mortality (61.2% vs. 35.9%, p < 0.001) and cardiovascular mortality (41.8% vs. 24.8%, p < 0.001), while the rate of revascularization (6.69% vs. 9.20%, p = 0.008) was lower. There were no significant differences in the risks of recurrent non-fatal myocardial infarction (10.7% vs. 10.8%, p = 0.935), recurrent stroke (10.90% vs. 9.48%, p = 0.08), and hemorrhagic stroke (0.82% vs. 0.74%, p = 0.806). Following adjustment for age, gender, KILLIP classification, medical history, and treatment strategies in a multivariable Cox regression analysis, impaired ADL remained an independent risk factor for increased all-cause mortality (aHR 1.167, 95%CI: 1.091-1.249, p < 0.001). Conclusions The decline in ADL is significantly associated with adverse clinical outcomes among NSTEMI patients.Baseline characteristics of patientsMedications of patients

AUMENTO DO USO DE ANSIOLÍTICOS APÓS A PANDEMIA – REVISÃO DA LITERATURA

Introduction: Anxiety disorders are significant areas of research due to the high incidence of anxiety being diagnosed in the population, leading to temporary or permanent disability. Investigations conducted on the mental health of Brazilian residents during the COVID-19 outbreak indicate an increase in diagnoses of anxiety, depression, and stress. The deterioration of mental well-being was influenced by multiple factors, including the absence of proper funeral ceremonies, the escalation of unemployment, and the decline in financial capacity, which heightened tension and anguish among those needing a source of income to support their families. This scenario significantly contributed to the increase in the use of anxiolytics, as many individuals resorted to these medications as a form of immediate relief for the symptoms of anxiety and stress exacerbated by the pandemic, highlighting the need for a broader and more integrated approach to mental health treatment in the current context. Objectives: To analyze the increase in the use of anxiolytics after the COVID-19 pandemic and its implications for public health. Methodology: This study is structured as a literature review, aiming to compile and analyze existing information on the topic. Additionally, the research is exploratory and descriptive, with the objective of mapping existing knowledge on the subject and outlining its nuances. The platforms Scielo, Portal de Periódicos CAPES, and Medline were used. The period considered was from 2018 to 2023, with texts fully available online, in Portuguese. Results: The results indicate a significant increase in the use of anxiolytics during and after the COVID-19 pandemic, especially among more vulnerable groups, such as the elderly and people with pre-existing health conditions. The use of medications like Alprazolam increased by 35% in 2020, reflecting the intensification of anxiety in the population. Conclusion: The pandemic exposed the fragility of mental health systems, highlighting the need for public policies that combine pharmacological treatment with continuous support. Future research is essential to monitor the long-term effects of anxiolytic use in the post-pandemic period.

Multi-stage ecological pond and reservoir system to enhance river water quality: demonstration study on Periurban River

ABSTRACT Pollution of urban rivers not only destroys the river ecology but also adversely affects the health of residents and urban landscape. In this regard, we selected a certain river in Wuhan for research. In this paper, we utilize the modified bypass multi-stage ecological pond reservoir system, set up the front parthenogenetic pond, aeration and oxygenation pond, ecological purification pond and other processes, supplemented with aeration–bacteriophage coupling, filler-type ecological floating island and other technologies to improve the water quality of the river. Results show that 4 months after the operation of the system, the rate of enhancement in water transparency reached 550%, and with a dissolved oxygen (DO) uplift rate of 322%, in addition, this system achieved 77.98, 77.78 and 74.41% removal of the ammonia nitrogen (NH3-N), total phosphorus (TP), chemical oxygen demand (COD) respectively, and the effluent water quality meets the target water quality standard. The process not only has a good pollutant removal effect, low cost and other characteristics but also can enhance the river landscape and improve biodiversity. It can provide a reference for similar river pollution water quality improvement.

Balance or Quality: Impact of Part-Time Farming on the Nutrition and Health of Rural Residents

The purpose of this paper is to explore the relationship between part-time farming and the nutrition and health of rural residents, test the possible effects through two potential pathways—income effect and time effect—and further analyze the family heterogeneity characteristic of downward intergenerational support. Using the ordered probit model and cross-sectional data from the China Rural Revitalization Comprehensive Survey (CRRS), which provide information on household income, health conditions, and nutritional caloric intake, this study estimates the relationship between part-time farming and the nutritional health of rural residents. The effects are decomposed into income (measured by dietary diversity scores and food consumption expenditures) and time effects (measured by excess caloric intake), with additional analysis on family heterogeneity concerning downward intergenerational support. Part-time farming positively correlates with rural residents’ nutritional health through two pathways: income effect (improved dietary diversity and increased food consumption) and time effect (negative impact of excessive caloric intake). Downward intergenerational support mitigates the negative time effect. This paper highlights the often-overlooked impact of part-time farming on rural nutrition and health, emphasizing non-linear effects and the significant role of downward intergenerational support, thus filling a gap in existing research.

Prevalence of Sick Building Syndrome Symptoms in Residents During the COVID-19 Pandemic—A Case Study of Suzhou City, China

Quarantine policies during the coronavirus disease 2019 (COVID-19) pandemic prolonged time spent at home, leading to an unintended occurrence of sick building syndrome (SBS) symptoms. The aim of this study was to investigate the prevalence of SBS symptoms among residents in Suzhou, China, during the COVID-19 pandemic. A questionnaire survey was conducted online from February to May 2022. A total of 442 adults were included in this study. The prevalence of SBS symptoms was much higher during the COVID-19 pandemic, and the proportions of general, mucosal, and skin symptoms were 59.3%, 45.5% and 49.1%, respectively. The influences of building characteristics, occupant lifestyle, indoor environment and perception of indoor environment were analysed using a multivariate logistic regression model. Neighbourhood pollutant sources, older residences, non-ownership and humidity indicators were significant risk factors for SBS symptoms. Frequent use of air fresheners was significantly associated with general (adjusted odds ratio (AOR): 4.9, 95% confidence interval (CI: 2.4–10.0), mucosal (AOR: 5.3, 95% CI: 2.4–11.5), and skin symptoms (AOR: 4.6, 95% CI: 1.6–13.1), while the use of disinfectants was significantly correlated with skin symptoms (AOR: 4.0, 95% CI: 1.5–10.7). Residents’ perception of an uncomfortable indoor environment was a significant predictor of general (AOR: 2.2, 95% CI: 1.2–4.0) and mucosal symptoms (AOR: 3.1, 95% CI: 1.6–6.0). The use of air cleaners can reduce the prevalence of general symptoms. An important finding of this study is that the psychological impact of staying at home for a long time was associated with general symptoms (AOR: 1.3, 95% CI: 1.1–1.7), which means that attention should also be paid to the mental health of residents during the COVID-19 pandemic. Although the quarantine period has now ended, our results can still serve as a reference for the impact of the indoor environment on the health of people with SBS, especially for those who stay at home for a long time, such as the elderly.

Scale-Dependent Effects of Urban Canopy Cover, Canopy Volume, and Impervious Surfaces on Near-Surface Air Temperature in a Mid-Sized City

Cities are significantly warmer than their surrounding rural environments. Known as the ‘urban heat island effect’, it can affect the health of urban residents and lead to increased energy use, public health impacts, and damage to infrastructure. Although this effect is extensively researched, less is known about how landscape characteristics within cities affect local temperature variation. This study examined how tree canopy cover, canopy volume, and impervious surface cover affect daytime near-surface air temperature, and how these effects vary between different scales of analysis (10, 30, 60, 90 m radii), ranging from approximate street corridor to city block size. Temperature data were obtained from a car-mounted sensor, with traverse data points recorded during morning, afternoon, and evening times, plotted throughout the city of Portland, OR. The variability in near-surface air temperature was over 10° F during each traverse period. The results indicate that near-surface air temperature increased linearly with impervious surface cover and decreased linearly with tree canopy cover, with canopy volume reducing the temperature by 1° F for every 500 cubic feet of canopy volume for evening temperatures. The magnitude of the effect of tree canopy increased with spatial scale, with 60 and 90 m scales having the greatest measurable effect. Canopy volume had a positive relationship on presumed nighttime and early-morning temperatures at 60 and 90 m scales, potentially due to the impacts of wind fluctuation and air roughness. Canopy cover still contributed the largest overall decrease in street-scale temperatures. Increasing tree canopy cover and volume effectively explained the lower daytime and evening temperatures, while reducing impervious surface cover remains critical for reducing morning and presumed nighttime urban heat. The results may inform strategies for urban foresters and planners in managing urban land cover and tree planting patterns to build increased resiliency towards moderating urban temperature under warming climate conditions.

Depression in the schistosomiasis japonica population based on the PHQ-9 scale: a cross-sectional survey from Jiangxi Province, China

Depression is the second leading-cause of disability in China. Although studies have shown that more than 80% of patients with advanced schistosomiasis (AS) suffer from anxiety and depression, these study groups are all hospitalized patients with AS and do not represent the extent of the disease in the whole group. To our knowledge, there are no studies assessing the severity of depression in patients with other forms of schistosomiasis japonicum. Therefore, it is necessary to evaluate the occurrence and potential risk factors of depression in the schistosomiasis endemic population. This cross-sectional study was conducted in Jiangxi Province, where schistosomiasis is relatively common in China, as the investigation site. The Patient Health Questionnaire-9 (PHQ-9) scale was selected to assess the depressive symptoms in the study population. At the same time, basic personal information of the research subjects and relevant socio-economics and schistosomiasis endemic area indicators were collected. The survey results show that AS has the highest incidence of depression (34.35%), while non-advanced schistosomiasis (N-AS) and control group (CG) have 22.35% and 22.24% respectively; the incidence of depression in AS is significantly higher than in N-AS and CG, while there is no statistical significance in the comparison between N-AS and CG; the incidence of mild depressive symptoms accounts for 61.08%-75.54% of the total incidence of depression in different groups; multivariate analysis shows that the occurrence of moderate/severe depressive symptoms in the AS group was significantly related to above 60 years old, male, the combination of other serious diseases, personal financial difficulties, and marshland and lake endemic areas. In the N-AS group, the occurrence of moderate/severe depressive symptoms was significantly related to the combination of other serious diseases, personal financial difficulties, significant correlation between marshland and lake endemic areas and the level of control of schistosomiasis epidemics. In conclusion, depression is still relatively common among patients with schistosomiasis patients, especially those with AS. It is recommended that the government and relevant departments consider mental health care when developing prevention and control work in schistosomiasis-endemic areas, in order to effectively protect the physical and mental health of schistosomiasis patients and residents in endemic areas.